August 26, 2019

August 2019: Advocacy Update

The last few months have seen significant movement across a broad array of issues:

APA Condemns Loss of Life from Gun Violence, Disputes Link to Mental Illness

Following the mass shootings in Dayton and El Paso, APA promptly released a statement condemning the loss of life due to gun violence and disputing any purported link between these events and mental illness. APA also joined six other physician and health professional organizations in calling for action to address the public health epidemic of firearm-related injury and death by recommending several evidence-based steps. Dr. Saul Levin, APA’s CEO and Medical Director, represented the Association on CNN, disputing claims that mental illnesses cause mass shootings.

You Can Help Bolster Meaningful MH/SUD Quality Measures

APA is developing quality measures and needs your expertise to ensure these measures meet the needs of psychiatrists treating those with mental and/or substance use disorders. By volunteering to be part of a learning collaborative through PsychPRO (APA’s clinical data registry), APA members can lend their voices to this important initiative. To learn more about the initiative and incentives for participation, please visit the APA Measure Development Initiative webpage.

APA CAN Members Advocate Locally on Mental Health Parity and Privacy Legislation

APA’s Congressional Advocacy Network (CAN) members capitalized on the Congressional August recess to meet with their federal lawmakers. CAN members arranged local meetings with their lawmakers and attended town hall meetings to advocate on behalf of APA’s Mental Health Parity Compliance Act and 42 CFR Part 2 reform legislation. The Council on Advocacy and Government Relations and APAPAC led this effort and provided advocates with educational resources like background materials, a guide to setting up meetings and a live webinar.

Want to get involved? Join APA’s CAN program today and help federal lawmakers better understand how the policies they pass affect your patients and community.

APA Calls for Protecting Access to Care for LGBTQ and Female Patients

APA opposed HHS’s proposed rule, Nondiscrimination in Health and Health Education Programs or Activities. The proposed rule would:

  • Eliminate discrimination protections based on gender identity and sex stereotyping and adopt broad abortion and religious freedom exemptions for health care providers, allowing LGBTQ patients or patients who have previously sought an abortion to be turned away from care.
  • Allow entities, such as insurers, to deny, limit, and impose additional cost-sharing for gender-specific services (such as cervical cancer screenings for women) or services related to gender transition (such as hormone therapy, mental health counseling, and surgeries) that a transgender patient may seek.
  • Eliminate language assistance services requirements for individuals with limited English proficiency.

APA’s comments focus on the unnecessary barriers to care the rule would impose and the associated costs in allowing for discrimination in healthcare. APA urges the Administration to rescind the rule to ensure that patients can seek without fear of being turned away. APA also joined a Group of Six statement and led a coalition letter with 30+ healthcare groups to Secretary Azar in opposition to the rule, when it was first announced in May.

APA Responds to CMS’s “Patients Over Paperwork” Initiative

APA responded to the Center for Medicaid and Medicare Services’ (CMS) Request for Information on “Reducing Administrative Burden to Put Patients Over Paperwork,” an initiative in its second year. In its letter, APA highlighted several areas of clinical and administrative burden endured by psychiatrists, including electronic health record and quality measurement reporting requirements on the Merit-Based Incentive Payment System. The comments also addressed concerns on prior authorization requirements and documentation requirements under Medicare.

APA Reviewing Key Proposals in the 2020 Physician Fee Schedule and Quality Payment Program

APA members and staff are reviewing proposals put forward by CMS related to reimbursement and quality measures. This includes a proposal to pay for services and medications provided by Opioid Treatment Programs (OTPs) and a proposed bundled payment for office-based management of patients with opioid use disorders. The rule also includes, effective as of 2021, a proposed increase in reimbursement for evaluation and management (E/M) services and an expansion of the ability to bill E/M services on the basis of time, removing the requirement that 50% of time must be spent in counseling and coordination of care. In addition, CMS has proposed a new MIPS framework – MIPS Value Pathways (MVPs) – which is expected to be less fragmented and focused on episodes of care (by specialty or clinical condition).

APA Weighs in on the Future of Artificial Intelligence in Psychiatric Care

The Office of Management and Budget (OMB) released a Request for Information (RFI), “Identifying Priority Access or Quality Improvements for Federal Data and Models for Artificial Intelligence Research and Development,” containing several prompts regarding the expansion of research and development in Artificial Intelligence (AI) across multiple industries, including healthcare. In its response, APA requested that multiple federal datasets be merged and be made public in order to capitalize on the future of AI in mental health. APA also expressed concern regarding the privacy and security of patient information in how AI may be used in the future of psychiatric care.

House of Representatives Passes Legislation to Improve Treatment of Immigrants in CBP Facilities

APA supports legislation introduced by Rep. Raul Ruiz, MD (D-CA) that would establish standards of treatment for individuals in Customs and Border Protection (CBP) facilities. Among those standards, the bill would ensure that immigrants receive routine and appropriate mental health and physical screenings upon entering U.S. custody. This legislation, H.R. 3239, the Humanitarian Standards for Individuals in CBP Custody Act, passed the U.S. House of Representatives in July.

APA Joins Physician Community to Address Surprise Medical Bills

As Congress works to draft legislation to protect patients from surprise medical bills, APA joined over 100 other physician organizations to voice support for an independent dispute resolution (IDR) processes in any proposal. The inclusion of this provision would address concerns that some policies under consideration might result in physicians getting unfairly reimbursed for their services. The IDR process would resolve payment disputes for out-of-network care, with the intent of encouraging health plans to make a fair initial payment offer and discouraging physician bills that outside a normal range.

APA Joins Mental Health and Community Advocates in Support of Trauma-Informed Care Legislation

Over 30 mental health and community organizations, including the APA, endorsed bipartisan legislation that would expand and further support a trauma-informed workforce in health care settings, schools and other systems as well as increase resources for communities to address the impact of trauma. This legislation, S. 1770/H.R. 3180, the Resilience Investment, Support, and Expansion (RISE) from Trauma Act, would:

  • Create a new program to monitor and enforce health insurance parity requirements for coverage of youth mental health services.
  • Recruit more mental health clinicians by increasing the funding for the National Health Service Corps loan repayment program.
  • Enhance several federal training programs to provide more tools for early childhood clinicians, teachers, first responders and selected community leaders.
  • Establish new federal grants that support hospital-based trauma interventions and community-based coalitions that coordinate stakeholders to address trauma.

APA Supports Legislation to Collect Information on Rising Law Enforcement Suicides

In light of the rising rate of law enforcement suicides, Rep. Mike Quigley (D-IL) introduced the Law Enforcement Suicide Data Collection Act, which would require the FBI to collect data on suicides from law enforcement agencies and submit a report to Congress on their findings. APA supports this legislation as a part of its longstanding commitment to work with the law enforcement community and to combat mental health stigma.

APA Marks the Close of Legislative Sessions and Plans for 2020

APA’s District Branches and State Psychiatric Associations are celebrating a very successful 2019 session so far now that many state legislatures are concluding their sessions. Among the many highlights this year:

  • 5 states enacted APA’s model parity legislation while many other states passed partial versions.
  • 9 states defeated psychologist prescribing legislation.
  • Illinois’s Governor is poised to sign collaborative care legislation into law.

Several states have full time legislatures that are still considering these important issues through the rest of the year. With next year’s legislative sessions fast-approaching, APA continues to collaborate with DB/SAs as they plan their agendas for the 2020 session. Are you ready for next year’s 2020 session? Sign up to receive action alerts and get involved when your state legislature is considering legislation that will impact your profession or your patients.

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